Provider Demographics
NPI:1396301578
Name:BABLOUZIAN, JENNA ELISE (DMD)
Entity type:Individual
Prefix:DR
First Name:JENNA
Middle Name:ELISE
Last Name:BABLOUZIAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:JENNA
Other - Middle Name:ELISE
Other - Last Name:SWOTINSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:ABINGTON FAMILY DENTAL CARE
Mailing Address - Street 2:477 WASHINGTON STREET
Mailing Address - City:ABINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02351
Mailing Address - Country:US
Mailing Address - Phone:978-460-1206
Mailing Address - Fax:
Practice Address - Street 1:ABINGTON FAMILY DENTAL CARE
Practice Address - Street 2:477 WASHINGTON STREET
Practice Address - City:ABINGTON
Practice Address - State:MA
Practice Address - Zip Code:02351
Practice Address - Country:US
Practice Address - Phone:978-460-1206
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-14
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN1858623122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist